title: Hematopoietic progenitor cell mobilization using low-dose cyclophosphamide and granulocyte colony-stimulating factor for multiple myeloma.
abstract: High-dose chemotherapy (HDT) supported by autologous stem cell transplantation (ASCT) has long been one of the standards of care for younger patients with multiple myeloma (MM). Cyclophosphamide (CY) plus granulocyte colony-stimulating factor (G-CSF) has been the conventional preparation for hematopoietic progenitor cell (HPC) mobilization, although the optimal dosage of CY in this setting has not yet been clearly defined. This study investigated the efficacy and safety of low-dose (LD-)CY (1.5 g/m(2)) plus G-CSF for conditioning for HPC apheresis harvest (HPC-A) in 18 MM patients, and compared it with a regimen consisting of intermediate-dose (ID)-CY (4 g/m(2)) plus G-CSF for 13 MM patients. Eleven patients in the former and six in the latter were treated with bortezomib (BTZ) during the induction therapy. Both regimens were comparably effective in terms of CD34(+) cell yields, while adverse events, such as leukopenia, thrombocytopenia, and febrile neutropenia, occurred significantly less frequently in the LD-CY cohort. All patients in LD-CY cohort started and completed their apheresis on day 7 or 8, whereas for the ID-CY cohort the day of first apheresis varied widely from day 8 to 15. These findings indicate that the LD-CY regimen is as effective as ID-CY for HPC mobilization, while the former is clearly more practicable and convenient than the ID-CY regimen for patients with MM.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimura
authors.forename: Junya
authors.initials: J
authors.lastname: Kuroda
authors.forename: Hitoji
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Eri
authors.initials: E
authors.lastname: Kawata-Iida
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tsutsumi
authors.forename: Hisao
authors.initials: H
authors.lastname: Nagoshi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Mizutani
authors.forename: Mio
authors.initials: M
authors.lastname: Yamamoto-Sugitani
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horiike
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shimazaki
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kaneko
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Taniwaki
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001781:Blood Component Removal; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D010954:Plasmacytoma / Q000628:therapy; D011719:Pyrazines / Q000008:administration & dosage; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D001897:Boronic Acids; D011719:Pyrazines; D016179:Granulocyte Colony-Stimulating Factor; D000069286:Bortezomib; D003520:Cyclophosphamide
keywords: G-CSF; cyclophosphamide; hematopoietic progenitor cell apheresis harvest; multiple myeloma